A Trailblazing Transplant: Man Survives Over 170 Days with Pig Liver
Medical professionals in China have achieved a groundbreaking feat. They successfully transplanted a genetically altered pig liver into a 71-year-old man, who then survived for 171 days post-operation, with 38 of those days living with the pig organ functioning inside his body. This pioneering case has been documented in a scientific journal.
Challenges and Potential of Animal Organ Transplants
Scientists have previously had success with transplanting genetically modified pig kidneys and hearts into humans. However, pig liver transplants have primarily been performed on patients who were already brain-dead. The idea of using a pig liver in a human transplant has raised some concerns within the medical community, due to the complex nature of the liver organ.
Many people have had reservations about liver transplants from pigs, considering the liver's complex functionality. However, this successful case may change future perspectives. The liver is a vital organ that performs multiple functions, such as filtering blood, removing toxins, processing nutrients, producing bile for digestion, and regulating blood sugar levels. It's larger than other organs and has a dual blood supply, making it more challenging to replace with an animal organ.
First Successful External Liver Perfusion with Pig Organ
In a landmark event, physicians managed to successfully perform an external liver perfusion using a gene-edited pig organ last year. The pig liver showed no signs of inflammation during the 72 hours it was tested, and the patient's body remained stable.
Another instance of a pig liver transplant to a brain-dead patient in China showed no signs of immune rejection or inflammation. However, the family requested to remove the organ 10 days post-surgery.
Hope for the Future of Organ Transplants
With thousands of people waiting for organ transplants, and especially liver transplants, the demand far exceeds the supply. Thus, the idea of using pig organs, which are similar to human organs, has been explored for many years. The case at hand, documented in a new scientific paper, offers hope for possible future procedures.
In this case, a liver from an 11-month-old genetically edited pig was transplanted into a 71-year-old man, initially hospitalized due to hepatitis B-related cirrhosis and a large liver tumor. Despite attempts to shrink the tumor, it was unsuccessful. A surgical removal of part of the liver was not feasible due to the patient's metabolic needs.
The patient developed severe abdominal pain three weeks into his hospital stay, with tests indicating a risk of tumor rupture. With no matching liver donors within the family, a genetically edited pig liver stood as the last resort to save the man's life. After discussing with his daughter, the man agreed to proceed with the experimental procedure.
Success and Setbacks
The transplant was initially successful. The pig liver turned red almost immediately, and bile secretion increased over time. There was a significant increase in liver function indicators and no immediate signs of inflammation or rejection.
However, around day 25, the patient's heart started showing signs of stress. Further tests revealed inflammatory changes linked to the transplant. Despite adjusting the immune-suppressing drugs, other indications suggested that the transplant was not functioning as well as it initially did. The patient developed a condition called xenotransplantation-associated thrombotic microangiopathy, where microscopic blood clots damage small blood vessels and organs.
On the 37th day post-surgery, the man’s blood pressure plummeted, his heart rate increased, and he fluctuated in and out of consciousness. His own liver was now capable of functioning well enough to sustain him, leading to the removal of the pig organ on day 38. His liver continued to function well afterward.
Unfortunately, 171 days post-transplant, the patient succumbed to upper gastrointestinal bleeding. But despite the outcome, the research provided valuable insights into the challenges and possibilities of such a transplant, bolstering cautious optimism for the future of xenotransplantation.